Journal of Ethnicity in Substance Abuse, 14:133–150, 2015 Copyright # Taylor & Francis Group, LLC ISSN: 1533-2640 print=1533-2659 online DOI: 10.1080/15332640.2014.973627

Drinking Motives and Alcohol Use Behaviors among African American College Students: The Mediating Role of Protective Behavioral Strategies MICHAEL B. MADSON, MARGO C. VILLAROSA, and KAYLA D. MOORER University of Southern Mississippi, Hattiesburg, Mississippi

VIRGIL ZEIGLER-HILL Oakland University, Rochester, Michigan

Drinking motives are robust predictors of alcohol use behaviors among college students. However, less is known about the link between drinking motives and alcohol use behaviors among African American college students. This study explored the associations between drinking motives and alcohol use behaviors in a sample of 215 African American college students. The study also assessed whether protective behavioral strategies mediated the associations between drinking motives and alcohol use behaviors. A direct relationship emerged between enhancement motives and alcohol consumption, harmful drinking and alcohol-related negative consequences. Protective behavioral strategies mediated each of these relationships. Clinical and research implications are discussed. KEYWORDS African American college students, alcohol use, drinking motives, protective strategies

Alcohol consumption among college students continues to be a public health concern as almost 50% of students have engaged in heavy episodic drinking (HED) at least once within the past 2 weeks (National Institute on Alcohol Address correspondence to Michael B. Madson, PhD, University of Southern Mississippi, Department of Psychology, 118 College Drive #5025, Hattiesburg, MS 39406-5025. E-mail: [email protected]. 133

134

M. B. Madson et al.

Abuse and Alcoholism [NIAAA], 2012). Researchers, university administrators, and student life personnel are interested in drinking patterns such as these because they are associated with relatively high rates of alcohol-related negative consequences reported by students (e.g., academic penalties, physical and sexual assaults, death; Borden et al., 2011). For example, every year alcohol-related injuries claim the lives of nearly 2,000 college students and an estimated 97,000 students are victims of alcohol-related sexual assault or rape (NIAAA, 2012). In fact, one of the most prevalent and concerning health problems among college students is alcohol-related negative consequences (e.g., Hingson, Zha, & Weitzman, 2009). For these reasons, researchers have focused on identifying risk factors and protective factors related to college student drinking. However, few studies have examined these behaviors specifically in African Americans and there is an increasing need to understand their alcohol use behaviors in order to develop culturally congruent alcohol interventions (Clarke, SU-Young, White, Yang, & Eun-Young, 2013; Madson & Zeigler-Hill, 2013; Paves, Pedersen, Hummer, & LaBrie, 2012). Thus, the purpose of the present study is to gain a better understanding of the links between drinking motives, alcohol use, and alcohol-related negative consequences as well as whether protective behavioral strategies mediate these links in a sample of African American college drinkers. Race is a factor that has been shown to influence a range of alcohol use behaviors among college students (Borsari, Murphy, & Barnett, 2007). For instance, African American college students consume less alcohol than students from other racial=ethnic backgrounds (Paschall, Bersamin, & Flewelling, 2005; Peralta & Steele 2009; Strada & Donahue, 2006), hold different expectations for drinking-related outcomes (Jung & Rojas, 2000), have different perceptions of normative drinking behavior (Rice, 2006), and differ in their experience and evaluation of alcohol-related negative consequences (e.g., White students reported more social, interpersonal, and risky behavior consequences; Skidmore, Murphy, Martens, & Dennhardt, 2012). Further, African American students report having fewer friends who engage in heavy drinking (Paschall et al., 2005) and perceive that drinking often takes place in areas occupied primarily—if not exclusively—by White non-Hispanic students (Peralta, 2010). It is also possible that African American students may avoid heavy episodic drinking in order to avoid trouble with campus authority officials (e.g., campus police; Peralta, 2010) or contributing to existing stereotypes about alcohol use among African Americans (e.g., ‘‘all African Americans abuse substances’’; Peralta & Steele, 2009). Thus, a better understanding of how predictors of alcohol use, such as drinking motives, relate to harmful and protective drinking behaviors in African Americans is needed. Drinking motives are one of the most robust predictors of risky and protective drinking behaviors among college students (Arterberry, Martens, Cadigan, & Smith, 2012; Cooper, 1994; Martens, Ferrier, & Cimini,

Drinking Motives and Protective Behavioral Strategies

135

2007; Martens, Rocha, Martin, & Serrao, 2008; Villarosa, Madson, Zeigler-Hill, Noble, & Mohn, 2014). African American college students hold different motives than other students for consuming alcohol (Paschall & Flewelling, 2002), which may relate to their risky and protective drinking behaviors. In a non-college sample, Neff (1997) found that African Americans drank more for escape and solitary drinking motives than White non-Hispanics and Hispanics. With college students, Griffin, Botvan, Nichols, and Sheier (2004) suggested that African American students may drink to manage negative mood states related to experiencing oppression and racism. Thus, it appears that African Americans may drink for motives related to feeling good or managing stress rather than other reasons such as conformity or increased sociability. Without looking specifically at racial groups, positively reinforcing drinking motives—such as increased sociability and enhancement motives (i.e., to feel good)—have been more predictive of moderate to heavy drinking, whereas negatively reinforcing motives—such as coping motives—have been associated with alcohol-related negative consequences (Kuntsche, Knibbe, Gmel, & Engels, 2005). In contrast, conformity motives have been more predictive of increased use of protective behavioral strategies (Patrick, Lee, & Larimer, 2011). Further investigation of the relationships that drinking motives have with risky and protective drinking behavior among African American college students is needed for developing more culturally congruent and effective prevention and intervention efforts. More specifically, it is important to better understand the link between specific types of drinking motives (i.e., positively reinforcing and negatively reinforcing motives) and drinking behaviors as well as the role of protective behavioral strategies in explaining these links. Protective behavioral strategies are self-regulatory drinking strategies such as ‘‘avoiding drinking games,’’ ‘‘using a designated driver,’’ and ‘‘knowing what you are drinking’’ that have been found to be associated with reduced alcohol consumption and fewer alcohol-related negative consequences (Madson, Arnau, & Lambert, 2013; Martens et al., 2007; Zeigler-Hill, Madson, & Ricedorf, 2012). Further, protective behavioral strategies have been shown to mediate the links that certain predictors of drinking behaviors (e.g., normative influences, outcome expectancies, intrapersonal states) have with alcohol consumption and alcohol-related negative consequences (Lewis, Rees, Logan, Kaysen, & Kilmer, 2010; Madson, Moorer, Zeigler-Hill, Bonnell, & Villarosa, 2013). For example, Martens et al. (2007) found that protective behavioral strategies partially mediated the relationships that positively reinforcing drinking motives (e.g., social and enhancement motives) had with alcohol consumption and alcohol-related negative consequences but protective behavioral strategies did not mediate the associations that negatively reinforcing drinking motives (e.g., coping and conformity motives) had with alcohol consumption and alcohol-related negative consequences. Positively reinforcing drinking motives have also been shown to

136

M. B. Madson et al.

predict less use of protective behavioral strategies across studies (e.g., Linden, Kite, Braitman, & Henson, 2014; Patrick et al., 2011). However, relatively little is known about how these associations may differ for individuals from different racial backgrounds. Given that racial differences have been found in the use of protective behavioral strategies (Labrie, Lac, Kenney, & Mirza, 2011; Lawrence, Abel, & Hall, 2010; Madson & Zeigler-Hill, 2013) and drinking motives (Griffin et al., 2004), it is important to examine the links that these variables have with drinking behaviors among a sample of African American college students. Further elucidating the links between drinking motives and protective behavioral strategies use among African American college students has the potential to more effectively promote protective drinking behaviors among these students. The present study will extend the results of previous research concerning drinking motives and drinking behaviors by examining the possibility that protective behavioral strategies may mediate these associations among African American college students. Although African American college students tend to have lower levels of alcohol consumption than many other students, the studies examining the factors that may contribute to this pattern have been limited (Peralta & Steele, 2009) and there is a dearth of research regarding the connection between drinking motives and protective behavioral strategies among African Americans. Given the importance of including drinking motives in alcohol interventions that focus on safe drinking behaviors (Linden et al., 2014), the purpose of the present study was twofold. The first purpose of the study was to better understand the direct relationship between different drinking motives and alcohol consumption, hazardous drinking and alcohol-related negative consequences. Based on previous findings that sociability and enhancement motives are associated with higher levels of alcohol consumption and conformity and coping motives are associated with alcohol-related negative consequences (Kuntsche et al., 2005), we anticipated that there would be significant direct relationships between enhancement and social motives and alcohol use behaviors and between coping and conformity motives and alcohol-related negative consequences among African American college student drinkers. Second, we sought to investigate the role of protective behavioral strategies in the associations that drinking motives have with alcohol consumption, hazardous drinking, and alcohol-related negative consequences among African American college drinkers. We expected that protective behavioral strategy use would mediate the connection that positively reinforcing drinking motives (i.e., social and enhancement) had with these outcomes but not mediate the associations that negatively reinforcing drinking motives (i.e., conformity and coping) had with these outcomes. In particular, we believed that the direct associations that sociability and enhancement motives had with alcohol consumption, hazardous drinking, and alcohol-related negative consequences would be explained, at least in part, by less use of protective behavioral strategies.

Drinking Motives and Protective Behavioral Strategies

137

These expectations are based on findings that protective behavioral strategies mediated the link that positively reinforcing drinking motives, but not negatively reinforcing motives, had with alcohol behaviors and that positively reinforcing motives predicted less use of protective behavioral strategies (Martens et al., 2007; Villarosa et al., 2014).

METHOD Participants and Procedures Participants were 215 African American undergraduates (58 men, 157 women) at a university in the Southern region of the United States who were enrolled in psychology courses and participated in return for partial fulfillment of a research participation requirement. Participants identified themselves as Black with ‘‘non-Hispanic’’ being implied because they did not also select the ‘‘Hispanic’’ option on the survey. Participants completed measures concerning their motivations for consuming alcohol, protective behavioral strategies used when consuming alcohol, alcohol consumption, harmful drinking patterns, and alcohol-related negative consequences via a secure website. The three criteria for participating in the present study were that the individuals had to (1) self-identify as African American or Black, (2) be between the ages of 18 and 25 (the average age for our participants was 19.93 years [SD ¼ 1.68]), and (3) have consumed alcohol within the past 30 days.

Measures MOTIVES FOR CONSUMING ALCOHOL Drinking motives were assessed using the 28-item modified drinking motives questionnaire (MDMQ; Grant, Stewart, O’Connor, Blackwell, & Conrad, 2007). Respondents were asked to indicate how often they consume alcohol for a particular reason using scales ranging from 1 (‘‘almost never=never’’) to 5 (‘‘almost always=always’’). The MDMQ consists of five subscales: social motives (5 items; e.g., ‘‘as a way to celebrate’’ [a ¼ .79]), enhancement motives (5 items; e.g., ‘‘makes me feel good’’ [a ¼ .85]), conformity motives (5 items; e.g., ‘‘to fit in with a group I like’’ [a ¼ .92]), coping with depression motives (9 items; e.g., ‘‘to forget painful memories’’ [a ¼ .95]), and coping with anxiety motives (4 items; e.g., ‘‘to reduce my anxiety’’ [a ¼ .81]). Researchers have shown that the MDMQ has demonstrated valid and reliable scores with college students (Martens, Rocha, Martin, & Serrao, 2008). PROTECTIVE BEHAVIORAL STRATEGIES The Protective Behavioral Strategies Scale (PBSS; Martens et al., 2005) is a 15-item instrument that was developed to identify the form and extent of

138

M. B. Madson et al.

PBS used by individuals when they are consuming alcohol. Participants responded to the items using scales ranging from 1 (‘‘never’’) to 6 (‘‘always’’). This instrument captures protective behavioral strategies that include serious harm reduction (e.g., ‘‘Use a designated driver’’), limiting=stopping drinking (e.g., ‘‘Alternate alcoholic and nonalcoholic drinks’’), and manner of drinking (e.g., ‘‘Avoid drinking games’’). Previous research has shown the PBSS to be associated with less alcohol use and fewer alcohol-related problems among college students (Benton et al., 2004; Martens et al., 2005, 2007). The internal consistency of the PBSS was a ¼ .93 for the present sample. AMOUNT OF ALCOHOL CONSUMED The alcohol consumption of participants was assessed using the daily drinking questionnaire (DDQ; Collins, Parks, & Marlatt, 1985). The DDQ identifies the amount of alcohol consumed by respondents by asking them to report their drinking behavior for the past week. The total number of alcoholic drinks consumed during the past week was calculated by summing the number of drinks reported for each day. A standard drink was defined as a 1.5 oz. shot of hard liquor, 5 oz. of wine, 10 oz. of wine cooler, or 12 oz. of beer. Scores for the DDQ have been found to be associated with other instruments designed to measure the amount of alcohol consumed such as the drinking practices questionnaire (Collins et al., 1985). HARMFUL DRINKING PATTERNS The Alcohol Use Disorders and Identification Test (AUDIT; Saunders, Aasland, Babor, De La Fuente, & Grant, 1993) is a 10-item instrument that assesses harmful drinking patterns (e.g., ‘‘How often do you have six or more drinks on one occasion?’’). The AUDIT is the leading instrument for the detection of early-phase risky drinking patterns across different cultures and age groups (e.g., Bradley, Bush, McDonell, Malone, & Fihn, 1998; Fiellin, Reid, & O’Connor, 2000; Reinert & Allen, 2002). The internal consistency estimate for the AUDIT was a ¼ .83 for the present study. ALCOHOL-RELATED NEGATIVE CONSEQUENCES The brief young adult alcohol consequences questionnaire (BYAACQ; Kahler, Strong, & Read, 2005) consists of 24 yes=no items that assess the alcohol-related negative consequences that individuals have experienced during the past year (e.g., ‘‘I’ve not been able to remember large stretches of time while drinking heavily’’). This instrument has been found to be a reliable and valid indicator of alcohol-related negative consequences among college students (Kahler et al., 2005). The internal consistency estimate for this instrument was a ¼ .89 for the present study.

Drinking Motives and Protective Behavioral Strategies

139

Data Analytic Approach A series of mediation analyses—using a macro developed by Preacher and Hayes (2008)—were performed to determine the extent to which protective behavioral strategies mediated the associations that the drinking motives had with alcohol-related outcomes (i.e., alcohol consumption, harmful drinking patterns, alcohol-related negative consequences). Preacher and Hayes (2004) recommend using a bootstrapping technique to conduct mediation analyses (i.e., bootstrapping is a nonparametric approach to effect-size estimation that makes no assumptions about the shape of the distribution of the sample). Our bootstrapping approach involved the extraction of 5,000 resamples with the mediational effect being calculated for each of these resamples and confidence intervals being estimated based on these resamples. In order to obtain the percentage mediated, the product of paths a and b for each mediator were divided by path c (Preacher & Hayes, 2004). We conducted three mediation analyses with drinking motives as the predictor variables, alcohol-related outcomes as the criterion variables, and protective behavioral strategies as the potential mediator for each analysis. This approach allowed us to assess the extent to which protective behavioral strategies mediated the associations that drinking motives had with each alcohol-related outcome.

RESULTS The means, standard deviations, and intercorrelations for the measures employed in the present study are displayed in Table 1. The mean number of drinks per week in this sample is slightly higher than those reported in African Americans elsewhere (O’Hara et al., 2014; Skidmore, et al., 2012). Results indicated that 54 women (38.2%) and 28 men (44.1%) reported engaging in heavy episodic drinking at least once within the past month. Overall, 41 participants (19.1% of the sample) exceeded the clinical cutoff for college students on the AUDIT (i.e., a score of 8), which indicates a significant risk for developing alcohol-related problems (Devos-Comby & Lang, 2008). According to the guidelines proposed by Collins and colleagues (1985), the majority of participants were classified as moderate drinkers (n ¼ 104, 48.4%) followed by light drinkers (n ¼ 76, 35.3%) and heavy drinkers (n ¼ 35, 16.3%). Finally, 50 women (31.8%) and 9 men (15.5%) met the standard established by the NIAAA (2009) for low-risk drinking.

Alcohol Consumption The results of the analysis that examined the mediating effects of the protective behavioral strategies for the associations that drinking motives had with the amount of alcohol consumed are presented in Figure 1. Enhancement

140

2 — .56 .68 .72 –.32 .36 .41 –.37 6.40 5.12

1 — .71 .32 .44 .59 –.20 .20 .25 –.25 8.30 4.85 — .87 .74 –.29 .28 .38 –.27 3.39 4.59

3

— .85 –.31 .32 .42 –.36 7.76 8.79

4

— –.30 .28 .40 –.36 4.24 3.69

5

— –.30 –.34 .34 76.04 20.05

6

— .56 –.41 6.93 7.39

7

— –.61 4.79 4.32

8

Note: DDQ ¼ Daily Drinking Questionnaire, AUDIT ¼ Alcohol Use Disorders Identification Test, BYAACQ ¼ Brief Young Adult Alcohol Consequences Questionnaire.  p < .05;  p < .01;  p < .001.

1. Social motives 2. Enhancement motives 3. Conformity motives 4. Coping with depression motives 5. Coping with anxiety motives 6. Protective behavioral strategies 7. Amount of alcohol consumed (DDQ) 8. Harmful drinking patterns (AUDIT) 9. Negative consequences of drinking (BYAACQ) Mean Standard deviation

TABLE 1 Intercorrelations and Descriptive Statistics

— 5.26 5.05

9

Drinking Motives and Protective Behavioral Strategies

141

FIGURE 1 The mediation model in which the associations that the drinking motives had with the amount of alcohol consumed were mediated by protective behavioral strategies. The path coefficients are included for the direct and indirect effects.  p < .05;  p < .01;  p < .001.

motives were the only drinking motives to have a direct association with alcohol consumption (c2 ¼ .36, p < .001). After including protective behavioral strategies in the model, the direct relationship between enhancement motives and alcohol consumption was reduced (c0 2 ¼ .32, p ¼ .004). This approach revealed that protective behavioral strategies mediated the association between enhancement motives and alcohol consumption (i.e., the bootstrap results indicated significant mediation because the 95% confidence interval for the indirect effect did not contain zero [CIlower ¼ .01, CIhigher¼ .10]) such that protective behavioral strategies accounted for 12% of the mediated effect. Enhancement motives were negatively associated with protective behavioral strategies (a2 ¼ .23, p ¼ .04) such that students reporting more enhancement motives were less likely to use protective behavioral strategies. In turn, protective behavioral strategies were negatively associated with the alcohol consumption (b1 ¼ .19, p ¼ .005) such that students who used fewer protective behavioral strategies reported consuming more alcohol.

Harmful Drinking Patterns The results of the analysis that examined the mediating effects of protective behavioral strategies for the associations that drinking motives had with harmful drinking patterns are presented in Figure 2. Enhancement motives were the only category of drinking motives to have a direct association with

142

M. B. Madson et al.

FIGURE 2 The mediation model in which the associations that the drinking motives had with harmful drinking patterns were mediated by protective behavioral strategies. The path coefficients are included for the direct and indirect effects. p < .05;  p < .01;  p < .001.

harmful drinking patterns (c2 ¼ .27, p ¼ .01). After including protective behavioral strategies in the model, the direct relationship between enhancement motives and harmful drinking patterns was reduced (c0 2 ¼ .22, p ¼ .04). This approach revealed that protective behavioral strategies mediated the association between enhancement motives and harmful drinking patterns (i.e., the bootstrap results indicated significant mediation because the 95% confidence interval for the indirect effect did not contain zero [CIlower ¼ .01, CIhigher¼ .12]) such that protective behavioral strategies accounted for 18% of the mediated effect. Enhancement motives were negatively associated with protective behavioral strategies (a2 ¼ .23, p ¼ .04) such that students reporting more enhancement motives were less likely to use protective behavioral strategies. In turn, protective behavioral strategies were negatively associated with harmful drinking patterns (b1 ¼ .21, p ¼ .001) such that students who used fewer protective behavioral strategies reported more harmful drinking patterns.

Alcohol-Related Negative Consequences The results of the analysis that examined the mediating effects of the protective behavioral strategies for the associations that drinking motives had with the alcohol-related negative consequences are presented in Figure 3. Enhancement motives were the only category of drinking motives to have a direct association with alcohol-related negative consequences (c2 ¼ .23,

Drinking Motives and Protective Behavioral Strategies

143

FIGURE 3 The mediation model in which the associations that the drinking motives had with the negative consequences of drinking were mediated by protective behavioral strategies. The path coefficients are included for the direct and indirect effects.  p < .05;  p < .01;  p < .001.

p ¼ .04). After including protective behavioral strategies in the model, the direct relationship between enhancement motives and alcohol-related negative consequences was reduced (c0 2 ¼ .17, p ¼ .12). This approach revealed that protective behavioral strategies mediated the association between enhancement motives and alcohol-related negative consequences (i.e., the bootstrap results indicated significant mediation because the 95% confidence interval for the indirect effect did not contain zero [CIlower ¼ .01, CIhigher ¼ .12]) such that protective behavioral strategies accounted for 23% of the mediated effect. Enhancement motives were negatively associated with protective behavioral strategies (a2 ¼ .23, p ¼ .04) such that students reporting more enhancement motives were less likely to use protective behavioral strategies. In turn, protective behavioral strategies were negatively associated with alcohol-related negative consequences (b1 ¼ .23, p < .001) such that students who used fewer protective behavioral strategies reported more alcohol-related negative consequences.

DISCUSSION One focus of this study was to better understand the direct association between different drinking motives and alcohol consumption, harmful drinking patterns, and alcohol-related negative consequences among African American college student drinkers. Most drinking motives studies are comprised of a White non-Hispanic majority and small samples of African

144

M. B. Madson et al.

American students, and this study helps to better understand the drinking patterns of African American students independently. Interestingly, only enhancement motives emerged as having a statistically significant direct relationship with alcohol consumption, harmful drinking patterns, and alcohol-related negative consequences. In other words, African American college student drinkers in this sample are drinking to ‘‘increase positive mood’’ or to ‘‘experience positive mood’’ (Cooper, 1995). This is slightly different than general trends in drinking motives research that support direct relationships between social, conformity, and coping motives and alcohol use behaviors and outcomes (Kuntsche et al., 2005). Given that African American students may perceive that alcohol consumption in college is predominately a White activity (Lawrence et al., 2010) and have fewer friends who engage in HED, they may be less focused on drinking to increase their sociability or to conform to the White majority. Similarly, African American students may be less likely to drink in situations that are generally considered to be ‘‘social’’ and that may be perceived as being occupied by mainly White students such as parties and bars (Peralta, 2005). Further, African American students may be more cautious of discriminatory targeting and avoid fostering alcoholrelated stereotypes when drinking in social situations because of their concern about possible consequences. For instance, Peralta (2010) discussed the existence of multiple standards for White and African American college students related to alcohol, which may lead to consequences such as police intervention or loss of respect for African Americans. Finally, Ebersole, Noble and Madson (2012) suggested that students who may feel marginalized on college campuses may be drinking to feel good and this may be especially true in social situations that may increase stress. Thus, although the current finding that only enhancement motives significantly predicted alcohol consumption, harmful drinking patterns, and alcohol-related negative consequences may have contradicted our initial hypothesis, it appears that African American college student drinkers are internally motivated to consume alcohol for positively reinforcing reasons (e.g., to feel better). Our hypothesis that protective behavioral strategies would serve as a mediator of the links that social and enhancement motives had with alcohol use behaviors but would fail to mediate the associations that coping and conformity motives had with these outcomes was partially supported. PBS did not emerge as a mediator in the connection between conformity and coping (for depression and anxiety) motives and drinking behaviors, which is consistent with previous protective behavioral strategy research (Martens et al, 2007). However, protective behavioral strategies only emerged as a mediator of the association that enhancement motives had with drinking behaviors. We found that African American students who were drinking more for enhancement motives used fewer protective behavioral strategies, which, in turn, was associated with greater consumption of alcohol, engagement in more harmful drinking, and experiencing more alcohol-related negative

Drinking Motives and Protective Behavioral Strategies

145

consequences. Although this is inconsistent with Martens and colleagues’ (2007) finding that protective behavioral strategies mediated the associations that social and enhancement motives had with alcohol consumption and alcohol-related negative consequences, Griffen and colleagues (2004) suggested that African American students, unlike White non-Hispanic students, are motived to drink more for internal states (e.g., to feel good) and less motivated to drink in order to increase their sociability. Perhaps it is the case that the use of protective strategies—which are often focused on limiting the consumption of alcohol—are seen as opposing the enhancement drinking motives among African American students. In other words, students drinking to feel good may perceive the use of strategies such as alternating alcoholic and nonalcoholic drinks or avoiding shots as minimizing their potential to ‘‘feel good’’ or ‘‘if some alcohol is good, more is better.’’ Additionally, given a perceived need for African American students to minimize their alcohol-related negative consequences and avoid reinforcing negative stereotypes concerning alcohol use, these students may be drinking in smaller groups and in ‘‘safer places,’’ which foster increased alcohol consumption and less use of individual protective behavioral strategies. Further, African American students may be using more preparatory and=or avoiding protective strategies. In other words, there may be culture-specific or group-based protective behavioral strategies that are not captured in the current measurement of protective behavioral strategies. The findings from the current study have several implications for alcohol prevention and intervention efforts with African American college student drinkers. There is an increasing emphasis on promoting safe drinking practices (e.g., protective behavioral strategies) as part of alcohol interventions (see Larimer et al., 2007). Additionally, Kite and colleagues (2014) recently emphasized the importance of addressing drinking motives in interventions aimed at increasing protective behavioral strategy use. Within the context of these results, interventions focused on increasing protective behavioral strategy use could help students become more aware of the links between drinking motives, especially to feel good, and alcohol-related behaviors, as well as how drinking motives may influence their use of protective strategies when drinking. These discussions could also address how students can continue to experience the positive consequences of drinking (e.g., to feel good) while also incorporating protective behavioral strategies in order to minimize the negative consequences of drinking. In fact, Pearson, D’Lima, and Kelley (2013) recently highlighted the need for protective behavioral strategy-focused interventions to not only emphasize minimizing alcoholrelated negative consequences but to also emphasize using protective behavioral strategies as a way to increase the positive effects of drinking. For instance, a clinician could elicit from the student which protective behavioral strategies are more and less facilitative of their drinking motives as well as how these strategies can be successfully implemented while continuing to

146

M. B. Madson et al.

experience the positive effects of alcohol. Further, clinicians can elicit other safe drinking practices not commonly endorsed to ensure the goals set by these students are achieved. At the level of group prevention, educational and social norming campaigns may benefit from providing group-specific information about drinking motives, social norms related to drinking, and protective strategy use given that proximal reference groups may have more influence on drinking behaviors compared with more distal groups (Neighbors et al., 2008). Thus, global prevention campaigns may be less effective than group-specific prevention approaches. Our results highlight the need for more research exploring predictors of risky and protective drinking behaviors among African American college students. Given that within group differences are often more salient than between group differences, continued research is needed that examines factors within African American college students that may predict safer drinking behaviors. For example, Madson, Moorer, and colleagues (2013) found that race and gender moderated the link alcohol expectancies had with drinking behaviors. More research is needed to better understand how factors such as expectancies, drinking context, and group affiliation (e.g., sorority=fraternity, athletic team affiliation) may predict harmful and safe drinking behaviors among African American college students. Similarly, research that evaluates the invariance of this model across gender is needed, as gender differences are common among alcohol-related variables (Hingson et al., 2009; Lewis et al., 2010; Madson et al., 2013). Additionally, given that African American college students are often among a racial minority group on many campuses nationwide, future research needs to address how factors such as acculturation, oppression, and experiences of microaggressions may be linked to alcohol use behaviors. Uncovering any associations that exist among these experiences and alcohol use behaviors can help to develop more culturally appropriate interventions and enhance cultural awareness among clinicians. Although these findings provide an additional understanding of drinking motives and alcohol consumption, harmful drinking patterns, and alcohol-related negative consequences among African American college students, study limitations call for caution in interpreting these results. This study was a cross-sectional design and therefore causal inferences cannot be made. The data were collected at one university, which may limit generalizability. Similarly, our sample, while representative of the university demographics related to gender, includes a strong majority of females, which could have affected the results and generalizability. Thus, future studies should incorporate longitudinal designs that include multiple universities and different regions of the country as drinking behaviors may vary based on these variables. In sum, our results highlight the differential impact of drinking motives on the drinking patterns of African American college students. In particular, African American students are participating in more problematic drinking

Drinking Motives and Protective Behavioral Strategies

147

(e.g., more alcohol consumption, harmful drinking patterns, and alcoholrelated negative consequences) when they are drinking to feel good (i.e., enhancement motives). Further, the lack of protective behavioral strategies utilized by these students when they are drinking to feel good may be contributing to their problematic drinking. Our results suggest that racial=ethnic background should be considered when tailoring harm-reduction efforts for college student drinkers.

REFERENCES Arterberry, B. J., Martens, M. P., Cadigan, J. M., & Smith, A. E. (2012). Assessing the dependability of drinking motives via generalizability theory. Measurement and Evaluation in Counseling and Development, 45, 292–302. doi:10.1177= 0748175612449744 Benton, S. L., Schmidt, J. L., Newton, F. B., Shin, K., Benton, S. A., & Newton, D. W. (2004). College student protective strategies and drinking consequences. Journal of Studies on Alcohol, 65, 115–121. Borden, L. A., Martens, M. P., McBride, M. A., Sheline, K. T., Bloch, K. K., & Dude, K. (2011). The role of college students’ use of protective behavioral strategies in the relation between binge drinking and alcohol-related problems. Psychology of Addictive Behaviors, 25, 346–351. doi:10.1037=a0022678 Borsari, B., Murphy, J. G., & Barnett, N. P. (2007). Predictors of alcohol use during the first year of college: Implications for prevention. Addictive Behaviors, 32, 2062–2086. Bradley, K. A., Bush, K. R., McDonell, M. B., Malone, T., & Fihn, S. D. (1998). Screening for problem drinking: Comparison of CAGE and AUDIT. Journal of General Internal Medicine, 13, 379–388. Clarke, N., SU-Young, K., White, H. R., Yang, J., & Eun-Young, M. (2013). Associations between alcohol use and alcohol-related negative consequences among black and white college men and women. Journal of Studies on Alcohol & Drugs, 74, 521–531. Collins, R. L., Parks, G. A., & Marlatt, G. A. (1985). Social determinants of alcohol consumption: The effects of social interaction and model status on the self-administration of alcohol. Journal of Consulting and Clinical Psychology, 53, 189–200. Cooper, M. L. (1994). Motivations for alcohol use among adolescents: Development and validation of a four-factor model. Psychological Assessment, 6, 117–128. Cooper, M. L., Frone, M. R., Russell M., & Mudar, P. (1995). Drinking to regulate positive and negative emotions: A motivational model to alcohol use. Journal of Personality and Social Psychology, 69, 990–1005. Ebersole, R. C., Noble, J. J., & Madson, M. B. (2012). Drinking motives, negative consequences, and protective behavioral strategies, in lesbian, gay, bisexual, and transgender (LGBT) college students. The Journal of LGBT Issues in Counseling, 6, 337–352. Fiellin, D. A., Reid, M. C., & O’Connor, P. G. (2000). Screening for alcohol problems in primary care: A systematic review. Archives of Internal Medicine, 160, 1977–1989.

148

M. B. Madson et al.

Grant, V. V., Stewart, S. H., O’Connor, R. M., Blackwell, E., & Conrad, P. J. (2007). Psychometric evaluation of the five-factor modified drinking motives questionnaire; Revised in undergraduates. Psychology of Addictive Behaviors, 32, 2611–2632. doi:10.1016=j.addbeh.2007.07.004 Griffin, K. W., Botvan, G. J., Nichols, T. R., & Sheier, L. M. (2004). Low perceived chances for success in life and binge drinking among inner city minority youth. Journal of Adolescent Health, 34, 501–507. Hingson, R., Zha, W., & Weitzman, E. (2009). Magnitude of and trends in alcoholrelated mortality and morbidity among US college students ages 18–24, 1998–2005. Journal of Studies on Alcohol and Drugs, Suppl. 16. Jung, J., & Rojas, R. (2000). Coping with a significant other’s problem drinking in relation to alcohol expectancies among Mexican-American and non-Hispanic White women. Journal of Alcohol and Drug Education, 45, 47–56. Kahler, C. W., Strong, D. R., & Read, J. P. (2005). Toward efficient and comprehensive measurement of the alcohol problems continuum in college students: The brief young adult alcohol consequences questionnaire. Alcoholism: Clinical and Experimental Research, 29, 1180–1189. Kuntsche, E., Knibbe, R., Gmel, G., & Engels, R. (2005). Why do young people drink? A review of drinking motives. Clinical Psychology Review, 25, 841–861. LaBrie, J. W., Lac, A., Kenney, S. R., & Mirza, T. (2011). Protective behavioral strategies mediate the effects of drinking motives among heavy drinking college students: Gender and race differences. Addictive Behaviors, 36, 354–361. Larimer, M. E., Lee, C. M., Kilmer, J. R., Fabiano, P. M., Stark, C. B., Geisner, I. M., et al. (2007). Personalized mailed feedback for college drinking prevention: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 75, 285–293. Lawrence, S. A., Abel, E. M., & Abel, E. M. (2010). Protective strategies and alcohol use among college students: Ethnic and gender differences. Journal of Ethnicity in Substance Abuse, 9, 284–300. Lewis, M. A., Rees, M., Logan, D. E., Kaysen, D. L., & Kilmer, J. R. (2010). Use of drinking protective behavioral strategies in association to sex-related alcohol negative consequences: The mediating role of alcohol consumption. Psychology of Addictive Behaviors, 24, 229–238. doi:10.1037=a0018361 Linden, A. N., Kite, B. A., Braitman, A. L., & Henson, J. M. (2013). Protective behavioral strategy use and motivations for drinking: Exploring alternatives to drinking strategies. Addictive Behaviors, doi:10.1016=j.addbeh.2013.10.008 Madson, M. B., Arnau, R. C., & Lambert, S. J. (2013). Development and psychometric evaluation of the revised Protective Behavioral Strategies Scale. Psychological Assessment, 25, 556–567. Madson, M. B., Moorer, K. D., Zeigler-Hill, V., Bonnell, M. A., & Villarosa, M. (2013). Alcohol expectancies, protective behavioral strategies, and alcohol-related outcomes: A moderated mediation study. Drugs: Education, Prevention & Policy, 20, 286–296. Madson, M. B., & Zeigler-Hill, V. (2013) Protective behavioral strategies, alcohol consumption, and negative alcohol-related consequences: Do race and gender moderate these associations? Journal Ethnicity & Substance Abuse, 12, 242–258.

Drinking Motives and Protective Behavioral Strategies

149

Martens, M. P., Ferrier, A. G., & Cimini, M. (2007). Do protective behavioral strategies mediate the relationship between drinking motives and alcohol use in college students. Journal of Studies on Alcohol and Drugs, 68, 106–114. Martens, M. P., Ferrier, A. G., Sheehy, M. J., Corbett, K., Anderson, D. A., & Simmons, A. (2005). Development of the protective behavioral strategies scale. Journal of Studies on Alcohol, 66, 698–705. Martens, M. P., Martin, J. L., Littlefield, A. K., Murphy, J. G., & Cimini, M. D. (2011). Changes in protective behavioral strategies and alcohol use among college students. Drug and Alcohol Dependence, 118, 504–507. Martens, M. P., Rocha, T. L., Martin, J. L., & Serrao, H. F. (2008). Drinking motives and college students: Further examination of a four-factor model. Journal of Counseling Psychology, 55, 289–295. doi:10.1037=0022–0167.55.2.289 National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2012). College Drinking. Retrieved from http://pubs.niaaa.nih.gov/publications/CollegeFactSheet/ CollegeFact.htm Neff, J. (1997). Solitary drinking, social isolation, and escape drinking motives as predictors of high quantity drinking, among Anglo, African American and Mexican American males. Alcohol and Alcoholism, 32, 33–41. Neighbors, C., O’Connor, R. M., Lewis, M. A., Chawla, N., Lee, C. M., & Fossos, N. (2008). The relative impact of injunctive norms on college student drinking: The role of reference group. Psychology of Addictive Behaviors, 22, 576–581. doi:10.1037=a0013043 O’Hara, R. E., Boynton, M. H., Scott, D. M., Armeli, S., Tennen, H., Williams, C., et al. (2014). Drinking to cope among African American college students: An assessment of episode-specific motives. Psychology of Addictive Behaviors, 28, 671–681. doi:10.1037=a003630 Paschall, M., Bersamin, M., & Flewelling, R. L. (2005). Racial=ethnic differences in the association between college attendance and heavy alcohol use: A national study. Journal of Studies on Alcohol, 66, 266–274. Paschall, M. J., & Flewelling, R. L. (2002). Postsecondary education and heavy drinking by young adults: The moderating effect of race. Journal of Studies on Alcohol, 63, 447–455. Patrick, M. E., Lee, C. M., & Larimer, M. E. (2011). Drinking motives, protective behavioral strategies, and experienced consequences: Identifying students at risk. Addictive Behaviors, 36, 270–273. doi:10.1016=j.addbeh.2010.11.007 Paves, A. P., Pedersen, E. R., Hummer, J. F., & LaBrie, J. W. (2012). Prevalence, social contexts, and risks for prepartying among ethnically diverse college students. Addictive Behaviors, 37, 803–810. doi:10.1016=j.addbeh.2012.03.003 Peralta, R. J. (2010). Raced and gendered reactions to the deviance of drunkenness: A sociological analysis of race and gender disparities in alcohol use. Contemporary Drug Problems, 37, 381–415. Peralta, R. J., & Steele, J. S. (2009). On drinking styles and race: A consideration of the socio-structural determinants of alcohol use behavior. Journal of Ethnicity and Substance Abuse, 8, 146–162. doi:10.1080.=15332640902897024 Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments & Computers, 36, 717–731. doi:10.3758=BF03206553

150

M. B. Madson et al.

Reinert, D. F., & Allen, J. P. (2002). The Alcohol Use Disorders Identification Test (AUDIT): A review of recent research. Alcoholism: Clinical and Experimental Research, 26, 272–279. Rice, C. (2006). Misperception of college drinking norms: Ethnic=race differences. Journal of Human Behavior in the Social Environment, 14, 17–30. Saunders, J. B., Aasland, O. G., Babor, T. F., De La Fuente, J. R., & Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption. Addiction, 88, 791–804. Skidmore, J. R., Murphy, J. G., Martens, M. A., & Dennhardt, A. A. (2012). Alcoholrelated consequences in African American and European American college students. Journal of Ethnicity in Substance Abuse, 11, 174–191. doi:10.1080= 15332640.2012.675248 Strada, M., & Donohue, B. (2006). Substance use in ethnic minority youth. Journal of Ethnicity in Substance Abuse, 5, 67–89. doi:10.1300=J233v05n01_05 Villarosa, M. C., Madson, M. B., Zeigler-Hill, V., Noble, J. J., & Mohn, R. S. (2014). Social anxiety and drinking behaviors among college students: The mediating effects of drinking motives. Psychology of Addictive Behaviors, 28, 710–718. Zeigler-Hill, V., Madson, M. B., & Ricedorf, A. (2012). Does self-esteem moderate the associations between protective behavioral strategies and negative outcomes associated with alcohol consumption? Journal of Drug Education, 42, 211–227.

Copyright of Journal of Ethnicity in Substance Abuse is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.

Drinking Motives and Alcohol Use Behaviors among African American College Students: The Mediating Role of Protective Behavioral Strategies.

Drinking motives are robust predictors of alcohol use behaviors among college students. However, less is known about the link between drinking motives...
498KB Sizes 1 Downloads 7 Views